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May/June 2010
Message from the Network Director VA Research - Helping Veterans The first and foremost mission of VHA is to provide exceptional health care that improves the health and well-being of individual Veterans. However, it has additional missions as well which include training the health care workforce of the future, research in areas of importance to Veterans and service in national emergencies. These additional missions support and complement the primary mission of providing health care to individuals. I would like to spend a short time today addressing the issue of research in the VA. One may ask how VA research benefits Veterans. First and foremost, the research VA does is focused on conditions of importance to Veterans, particularly those related to their medical service. VA leads the world in research on PTSD. Another example is the work VA has done on development of new and improved artificial limbs. This research has contributed directly to quality of the care we deliver today and contributes to even better care for Veterans in the future. Having research as part of our work also gives patients access to many new, cutting edge tests and treatments which may not be available to the general public. Finally, research allows us to attract the best and brightest doctors, nurses and other providers to join our staff and dedicate their careers to VA. Research is of particular importance to VA New England Healthcare System. It does more research than any other network except southern California. It receives funding of over 150 million dollars and employs over 500 individuals in its research projects. Our research efforts are helped by affiliation with many of the country’s finest universities and the fact that we are located in a region of the country that has one of the largest, if not the largest, concentration of bio-medical research in the world. One of our strategic goals is to develop a research strategic plan. Under the leadership of Dr. Arana, chief medical officer, we are making significant progress in this area. We recently started a program to support young researchers at the very start of their career to help them obtain independent funding. An impressive array of young men and women submitted exciting ideas that would lead to new knowledge for Veteran care. We have also recently formed a special contracting team to work with our research and resource centers. They face unique contracting challenges that have in the past slowed their efforts to expand research programs. We are also working with local leadership at places like Northampton and Togus to initiate meaningful research programs where none existed before. In this issue of New England Connections is a description of the Million Veteran Program (MVP). This program will be based in Boston and is an exciting example of the world-class research that we do. Please take a moment to read about it, as I believe it will be one of the premier genetics research programs in the United States. No other health care system in the country offers the opportunity to enroll such a large number of individuals who could donate genetic material which can then be matched to the information contained in a comprehensive electronic medical record. Research programs are a great strength of VISN 1. Our efforts to support and grow these research activities are another example of our commitment to expand our services to this area’s Veterans. Sincerely, Michael F. Mayo-Smith, MD, MPH
ELB Matters: Veteran-Centric Care In keeping with Secretary Shinseki’s vision of VA becoming more "Veteran-centric," the VISN1 Executive Leadership Board (ELB) met May 4-6, 2010, at the VA Connecticut HCS, West Haven campus, where the resounding theme was Patient-Centered Care. This is a fundamental shift in the treatment model that places the needs and expectations of the patient at the center of our efforts. Organizations that are on the forefront of this philosophy have witnessed increases in patient enrollments, employee job satisfaction and in the organizations’ standing in comparison to their peers. Thanks to the planning efforts of our ELB support staff, we were fortunate enough to participate in presentations by organizations on the forefront of patient-centered care to include Griffin Hospital in Conn., who turned a troubled medical center into a center of health care excellence through their adoption of the patient-centered care model. Staff from VISNs 7 and 22, along with the Atlanta VAMC, shared some best practices in patient-centered care and how it can be done with the same mix of facility types and vintages that we share in VISN1. Here are some highlights of the May 25 ELB meeting:
The ELB will continue to keep you updated as we move closer to our ultimate goal of achieving health care excellence through Veteran-centric, patient-centered care.
VHA Announces 2010 Survey of Veteran Enrollees The Veterans Health Administration (VHA) is conducting the 2010 update of the national VHA telephone Survey of Enrollees. The purpose of the survey is to provide information that is incorporated into annual VHA projections of enrollment, utilization, and expenditures, as well as into a variety of high level VHA budget and policy related analyses. The survey provides critical and essential information on Veteran utilization of health services, projecting the resources and services needed in VHA, and in developing VA’s budget. The survey collects information on a random sample of 42,000 Veterans enrolled in the VA system, who participate in a 15-30 minute telephone survey. Each VISN will have approximately 2,000 enrollees surveyed. The survey was fully initiated the week of May 24, 2010. Interviewing will continue for 12 weeks. Veteran enrollees selected for the survey will receive a letter that provides information about the survey and the contractor conducting the survey on behalf of the VA.
VA Physician Recognized for Outstanding Work in Pain Management
As National Program Director for Pain Management, Dr. Kerns is responsible for developing policy and overseeing VHA’s national pain management strategy. He directs an interdisciplinary team of clinical, research, and training professionals within VA Connecticut Healthcare System, and is a professor of psychiatry, neurology, and psychology at Yale University. Dr. Kerns served as chief of psychology at VA Connecticut from 1987 to 2009, at which time he became Director of the PRIME Center.
VA Genomic Medicine Program: Million Veteran Program The Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) located at the VA Boston Healthcare System is involved in the VA Genomic Medicine Program. Genomics is the study of all the genes in an individual as well as the function and interactions of those genes with each other and with the individual's environment. J. Michael Gaziano, MD, MPH, is the director of MAVERIC. The VA Genomic Medicine Program, called the "Million Veteran Program," will create a national resource for current and future genomic research initiatives to improve health care to Veterans. Up to 1 million Veterans will be enrolled into an observational cohort. The program aims to collect health and lifestyle information, blood collection for storage in a bio-repository, and provide access to an electronic medical record. Recruitment of participants will be coordinated by MAVERIC. The vision of the VA Genomic Medicine Program is to improve the health and quality of life of our Veterans, by applying what we learn from genomic medicine research to provide personalized medicine to treat and to prevent disease and other medical conditions. Learn more: www.research.va.gov/programs/csp/boston.cfm
VISN 1 Receives Innovation Funding Earlier this year, VHA solicited proposals to support and facilitate VHA’s transformation into a culture of patient-centered care. Funding for accepted proposals is intended to leverage cultural transformation by implementing an innovation that will result in new or altered processes for delivery of patient-centered care. VISN 1 received funding for three proposals:
VHA received approximately 550 proposals. A total of 48 proposals were selected for funding which totaled $23 million. Proposals were evaluated by a team of reviewers appointed by the VHA Advisory Committee on Patient-Centered Care. Evaluation criteria included: likelihood of success, potential impact on supporting the development or enhancement of a patient-centered culture, links to one or more the VHA twelve patient-centered care principles, and exportability of the innovation.
Bedford VAMC Receives VA American Spirit Award Bedford VAMC received the 2009 VA Voluntary Service (VAVS) “American Spirit Award” for their efforts in the Military Recruitment category. The award recognizes Bedford VAMC’s strong affiliation with active duty military volunteers from Hanscom Air Force Base and other components of the armed forces.
The award was presented on April 7, 2010 at the 64th Annual VA Voluntary Service National Advisory Committee Meeting in Cincinnati, OH.
Marc Levenson, MD As Director of Manchester VAMC it is my duty to promote ethical decision making and behavior at all levels of the medical center. One of the biggest challenges to this goal is communications barriers. We have formed a Preventive Ethics team to assess the current status of communication methods at the medical center including the development of an all-employee survey. The team will report its recommendations to the Integrated Ethics Council and to medical center leadership. These actions will enable us to improve our ability to educate our staff and share with them ethical concerns. We have already begun to have a lunch meeting for all new employees, during orientation, to communicate the ethical goals of the organization. The Ethics Staff Survey showed us that employees wanted a better understanding of ethical decision making regarding resource allocations. We have formed a task force to review the problems associated with this issue and develop recommendations to leadership on how to optimize distribution of resources based on medical center allocation. It is anticipated that these recommendations will enable the medical center to apply ethical principles in resource allocation decisions. Our ethics consultation team is very active. We have increased the visibility of this group at staff meetings as well as through written communication with employees. The topics that staff raised with the team have widespread application. Several of these topics include:
The result of these activities has been to raise awareness of ethical concerns among all our staff. I appreciate the honesty of members of the Integrated Ethics Council as we discuss ways of making ethics more visible and applicable to each employee.
Congratulations Louis H.G. Bier, chaplain, VA Boston HCS, received the Retired Chaplain Award from the Association of Professional Chaplains. The award is presented to a retired member who has made significant contributions to the field of professional chaplaincy during retirement years. Louis Bier has been serving in the VA Boston HCS as a staff chaplain for more than 40 years. VA Boston HCS was recognized by the Association of Diversity Councils as one of the Top 25 organizational diversity councils in the U.S. during the Diversity Council Honors Award Reception at the 11th Annual Summit on Leading Diversity Conference in Atlanta. VA Boston HCS ranked 22. Four employees at VA Boston HCS were recognized with a Greater Boston Federal Executive Board Excellence in Government Award during a ceremony in Quincy, Mass., on May 5:
VA Connecticut HCS Care and Case Management Program was named the winner in the inaugural “Case in Point” platinum awards in the categories of Integrated Case Management Program and Military Case Management Program. The awards recognize the most successful and innovative case management programs working to improve health care across the care continuum. The awards honor programs that best educate and empower patients, improve adherence and wellness, manage quality care and contain healthcare costs. Providence VAMC staff were recently recognized at the 75th Annual Disabled American Veterans (DAV) State Convention in Warwick, R.I.:
John Roefaro, PharmD, pharmacist, VA Boston HCS, received the Louis P. Jeffrey Award for Outstanding Career Achievements in the Pharmacy Residency Program. The Jeffrey award is awarded annually to an Eastern States Conference preceptor for distinguished service to the profession and commitment to residency training. Sharon Rounds, MD, chief of medical service, Providence VAMC, and professor of Medicine and Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, was awarded of the 2010 Woman Physician of the Year by the Rhode Island Medical Women’s Association. The ceremony occurred during the Association’s 29th anniversary celebration event on May 4, 2010, at the Providence Marriot Hotel. Jeannette Spencer, RN, joined the VISN 1 team as the new Patient Safety Officer on May 24. Ms. Spencer has served as the national nurse executive for the VA Surgical Quality Assurance Program (VASQIP) since 1993. She started her VA career in 1986 as a cardiopulmonary clinical nurse specialist at West Roxbury VA. She has also held positions in Quality Management, Risk Management and Nursing Education. She has participated in numerous research studies and has authored both articles and book chapters in the areas of quality outcomes, medical peer review, risk adjustment, and quality improvement. Ms. Spencer is a graduate of Southeastern Massachusetts University and Boston University. Pradeep Suri, MD, staff physiatrist, VA Boston Healthcare System, was awarded the Best Poster Award at the 2010 Association of Academic Physiatrists Annual Meeting. Dr. Pradeep’s research poster was titled “Bias in the Physical Examination of Patients with Lumbar Radiculopathy.” The study demonstrates that prior knowledge of lumbar spine MRI findings influences the perceived accuracy of the physical examination, for patients with lumbosacral radicular pain. Martin Weinstock, MD, chief of dermatology, Providence VAMC, was recognized as the 2010 recipient of an American Skin Association (ASA) Achievement Award for his important contributions to the understanding of Skin Cancer/Melanoma. Dr. Weinstock received a plaque at the Society for Investigative Dermatology meeting at the Hilton Atlanta Hotel, Atlanta, Ga., on May 6, 2010. Cindy Williams, LICSW, CDP, VISN 1 OEF/OIF case management coordinator, was selected as a 2010 Alumni Award and Honor Roll Recipient at Rhode Island College.
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Dr. Robert Kerns, VHA Office of Patient Care Services, has been recognized by the American Pain Society for his contributions to the field of pain management. Dr. Kerns received the prestigious John and Emma Bonica Public Service Award during the American Pain Society’s 29th Annual Scientific Meeting in Baltimore, Md., in early May. The John and Emma Bonica Public Service Award is named after two pioneers in the field of pain management.
VA Secretary Eric Shinseki presented the VA Voluntary Service “American Spirit Award” to Linda Mitchell, Voluntary Service specialist, Bedford VAMC. Ms. Mitchell accepted the award on behalf of the entire VAVS Committee at Bedford VAMC.
Communication is Key to Raising Awareness about Ethics